More than medical care: Sexual Assault Nurse Examiners

Last week, some 100 forensic nurses from around the country gathered in Washington DC, seeking help with funding for research, education and prevention efforts related to sexual assault. It's an ongoing battle to represent the needs of patients who rarely speak for themselves.

Here in Kittitas County, we're nearing the 6-year mark of our local Sexual Assault Nurse Examiner (SANE) program at KVH Hospital. The program involves a collaborative effort between local law enforcement, ASPEN, CWU, and the hospital; in every situation, trained staff are involved from the initial report of assault through the victim's medical examination.

Ask any SANE and you'll find a person who cares deeply about the care and treatment of sexual abuse victims. "It's very emotional," says Pam Clemons, RN and SANE at KVH Hospital. "One of the most important responsibilities we have is to be objective - but it's not always easy."

Objectivity for SANEs is key, because they are not only caring for and treating patients - they're also collecting evidence. The SANE program is an example of forensic nursing, providing specialized care for victims and perpetrators of intentionally and unintentionally inflicted trauma. Forensic nurses have a specialized knowledge of the legal system and skills in identifying, evaluating and documenting injuries. According to the International Association of Forensic Nursing, after attending to a patient’s immediate medical needs, a forensic nurse often collects evidence, provides medical testimony in court, and consults with legal authorities.

As an emergency room nurse, Clemons was already familiar with helping patients in crisis situations. Then she saw an unmet need in care for sexual assault victims. "I thought, I can do this. I took the training, and the passion I now have grew out of my experiences."

The nature of emergencies and traumas is unpredictable and unplanned, which means Clemons and other SANE professionals can't predict how many patients they'll see in a given month. Clemons says, "For some reason, patients often come in waves. We won't see any for months, and then have 3 in one weekend."

Weekends treating multiple sexual assault victims are tough on these examiners. The emotion and empathy, combined with heightened awareness needed not just for physical care, but forensic procedures, can quickly drain a nurse's energy. But the sense of satisfaction that comes with helping victims can be almost as overwhelming. It's one reason why Clemons encourages others who are interested to seek out SANE training. "Every time a nurse joins the group, we learn something from them," she says. "They bring ideas and past experiences that give us a fresh perspective on what we're doing."